This case and video supplement recount three high-profile public health decisions that German Minister of Health, Jens Spahn, made during the first year of the COVID-19 pandemic: how to procure masks, which vaccines to procure (and how many doses), and whether to pause AstraZeneca vaccine distribution after preliminary evidence linked it to a rare lethal side effect. These inflection points called on Spahn to evaluate tough tradeoffs and rapidly execute a series of high-stakes decisions with limited information, and under intense public scrutiny. In April of 2020, amid a global scramble for coveted N95 face masks and a wildly fluctuating market, Spahn procured millions of masks for German health care workers at the high cost of 4.50 Euros each. The decision garnered bad press just a few weeks later as supply chains relaxed, and mask prices plummeted. The following month, Spahn led Germany to secure contracts with as many vaccine manufacturers as possible and spearheaded a push for the European Union to negotiate vaccine procurement as a unified bloc. To achieve this, Germany had to assume a greater share of the purchasing risk than other EU countries and purchased significantly more vaccine doses than they would have otherwise. Then in March 2021, having received preliminary evidence that the AstraZeneca vaccine was linked to a rare but potentially fatal side effect, Spahn paused distribution of AstraZeneca in Germany. This case includes a 14:38 video supplement in which Jens Spahn revisits his approach to these key decisions, the factors that influenced his thinking and some of the lessons learned. HKS Case No. 2269.0

IDinsight, an evaluation company founded by graduates of the Harvard Kennedy School, designs and conducts evaluations that best suit the needs of clients across the developing world, offering timely and rigorous evidence to help decision making. In 2014, USAID approached IDinsight to conduct an evaluation of an affordable solar lantern developed by another social organization, d.light. IDinsight would have to assess whether d.light's innovation was worth subsidizing and scaling in other parts of Africa and the world. This case describes the decisions and challenges IDinsight faced when conducting the evaluation and presents the results of the evaluation for students to consider. This case includes a 10:45 min. video where Neil Buddy Shah, CEO and Co-Founder of IDinsight, describes the company's approach to evaluating anti-poverty programs in developing countries. Shah also explains what evaluation design was ultimately chosen, why, and what the results of the evaluation were. Segments from the video can be used as a way to reveal this information as part of the class discussion.

In 2013, Educate Girls (an Indian nonprofit working to increase the number of girls enrolled and learning in school), partnered with Instiglio, a startup specializing in financial instruments for social programs in developing countries to create the first Development Impact Bond-a financial instrument similar to a Social Impact Bond. UBS Optimus, a Swiss foundation, agreed to act as the investor and the London-based Children's Investment Fund Foundation would reimburse UBS Optimus' initial investment and pay returns if Educate Girls met or exceeded a set of predetermined goals. Instiglio would broker the deal and IDinsight, a new evaluation organization would conduct the evaluation. Agreeing on the evaluation design, however, proved challenging. An evaluation was vital to the DIB because success payments hinged on its findings, but Educate Girls was concerned that the investors and evaluators were not considering the realities of program implementation when proposing complex evaluation methods. Whereas, the investors and evaluators were not interested in backing a DIB where the impact findings could be open to question. This case places students in the decision room with the DIB parties and asks them to grapple with the tradeoffs social organizations and evaluators often have to face. The 8-minute video supplement can be used toward the end of the class discussion to reveal to students how the parties resolved their differences and signed on to the DIB.

In July 2012, three freshly-minted Harvard Kennedy School graduates bought one-way tickets to Medellin, Colombia, to launch a nonprofit startup they called Instiglio. Their idea: to bring Social Impact Bonds, still experimental even in affluent nations, to Colombia and other low to middle income countries. This statistics case-one of two nearly identical HKS cases about Instiglio-provides background about the SIB model (a financing mechanism for experimental social programs, with private investors shouldering the financial risk of failure) and tracks the early experience of the HKS graduates in Colombia. The case includes a summary of the issues the group faced in designing a first draft SIB agreement, including several questions about evaluation design and tricky issues in structuring a payment system. The other HKS Instiglio case, HKS case number 2026.0, "Betting Private Capital on Fixing Public Ills: Instiglio Brings Social Impact Bonds to Colombia," intended for a policy analysis course, emphasizes the process of selecting a project, given limited information and political complexities. Case number 2043.0

This video-based case explores how an impact evaluation for a promising after-school program in New York City went awry. In 2006, New York City's Mayor Michael Bloomberg created the Center for Economic Opportunity (CEO). Designed as an innovation fund, CEO tested anti-poverty programs by applying an evidence-based approach. One of CEO's programs, Teen ACTION, was developed to provide after-school service-learning opportunities to at-risk youth. Teen ACTION's model was based on a rigorously evaluated program which had proven to significantly reduce rates of teen pregnancy and course failure among participants when compared to a control group. But when it came time to evaluate Teen ACTION's impacts, CEO ran into significant hurdles. With rare candor, CEO officials, Kristin Morse and Carson Hicks discuss on video how flaws in the program's evaluation strategy, coupled with random unforeseen events like the Swine Flu, rendered the evaluation results unusable. HKS Case Number 2027.0.

In July 2012, three freshly-minted Harvard Kennedy School graduates bought one-way tickets to Medellin, Colombia, to launch a nonprofit startup they called Instiglio. Their idea: to bring Social Impact Bonds, still experimental even in affluent nations, to Colombia and other low to middle income countries. This public policy case-one of two HKS cases about Instiglio-provides background about the SIB model (a financing mechanism for experimental social programs, with private investors shouldering the financial risk of failure) and tracks the early experience of the HKS graduates in Colombia. The case focuses on two of the most critical decisions the Instiglio group faced: (1) how to pick a project topic, in the midst of competing demands and limited information and (2) with a project topic in hand, how to design a SIB agreement that would satisfy the needs of both investors and government leaders. A second case on this topic, ''Devil in the Details: Designing a Social Impact Bond Agreement in Medellin,'' is a statistics case. It includes much of the same background information as ''Betting Private Capital,'' but hones in on the technical challenges of designing a SIB agreement. HKS Case Number 2026.0.

When the Mexican Congress approved the country's 2007 budget, it included an appropriation of 8.5 billion pesos allocated to provide non-contributive pensions to senior citizens. President Felipe Calderon wanted to introduce eligibility criteria that would ensure the new federally-funded pensions would go to poor seniors that would otherwise lack the means to sustain themselves. This case puts the reader in the shoes of Calderon's advisor, asking them to assess which targeting option would be best for the Mexican government, taking into account a wide range of criteria including targeting efficiency, financial feasibility, political viability, and administrative feasibility. The case provides a brief description of previous efforts to target the poor in Mexican social programs and data to evaluate three potential targeting options. Case Number 2011.0

In late 2006, New York City Mayor Michael Bloomberg created the Center for Economic Opportunity (CEO). Born out of recommendations made by the Bloomberg appointed public-private Commission for Economic Opportunity, CEO was designed to be an innovations lab that would test anti-poverty programs by applying a results-based approach. With a budget of $100 million, CEO would closely monitor new programs and hold them accountable for producing measurable results. Uniquely, CEO would cut funding for programs that did not "make the grade." Bloomberg named Veronica White the Executive Director of CEO. White had decades of experience working in executive positions in several New York City agencies but with CEO she had daunting tasks ahead. She would have to redefine how poverty was measured in the city, facilitate cross agency partnerships, and most important, develop an effective and achievable evaluation system for all programs. This case traces the CEO team's challenges in placing program evaluation at the core of their mission. CEO programs are geared toward three target populations-working poor adults, young adults between the ages of 16 and 24, and families with children ages five and below. In the first year of operation, White and her team launched a slate of anti-poverty programs that varied widely in scale and scope and ranged from New York's first ever conditional cash transfer program to a program that would accelerate graduation rates in community colleges. But from the beginning, CEO's evidence-based programming was put to the test. White faced constant pressure to "produce results quickly." With the 2008 recession, however, CEO endured significant cuts in its evaluation budget. White and her team had to make the most of limited resources while still sustaining a comprehensive evaluation policy. Case Number 1971.0

This case asks participants to put themselves in the position of a government official in charge of selecting an evaluation design to assess the impact of a social program. The goal is to illustrate the tradeoffs that are made in the real world when trying to balance the desire for a rigorous and credible evaluation design with the logistic, political, financial and ethical constraints that so frequently arise in evaluating social programs. Participants are asked to assess the strengths and weaknesses of three possible evaluation designs using as criteria the scientific rigor, political feasibility, logistical implications, and financial feasibility of each design. The case includes a 5:30-minute video interview with Jason Wilks, a Senior Policy Analyst with the team in charge of monitoring the PATH Program for the Jamaican government. Wilks describes the political context in Jamaica at the time and the internal and external pressures the government was under as it considered the three evaluation designs. The video contains three short segments that can be played throughout the class and a 3-minute "reveal" where Wilks explains the government's ultimate decision. The four segments can also be played sequentially at the end of the case discussion.